Strabismus in children is associated with an elevated risk of anxiety disorder, schizophrenia, bipolar and depressive disorders, a cross-sectional study suggests.

US researchers say their findings should prompt the referral of paediatric patients who present with the eye condition for mental health evaluation.

“Physicians and parents will need to be more vigilant in children with strabismus to observe for signs of any mental illness, but especially anxiety, depression and schizophrenia,” said study author and paediatric ophthalmologist Dr Stacy Pineles.

In their cross-sectional study, Dr Pineles and colleagues at the University of California, Los Angeles analysed insurance claims data from more than 12 million children (mean age 8), of whom some 353,000 had strabismus in the form of esotropia, exotropia or hypertropia.